Manager, Revenue Integrity Operations

Position Summary

The Manager, Revenue Integrity Operations is responsible for leading and manages a variety of Revenue Integrity positions as the department needs warrant to include Liaisons, Service Line Coordinator and Assistant Managers. The incumbent holds expert understanding of the hospital revenue cycle and makes sure direct reports monitor designated areas of responsibility and ensure capture of appropriate revenue through the ongoing monitoring of Medicare and other Payer regulatory and compliance changes. This role identifies revenue opportunities and assists direct reports to formulate plans that will provide process improvement. This position develops and enforces the vision, direction, and planning for provision of charge capture, charge management and all education and training programs.

Schedule: Hybrid, Monday through Friday, 8am to 5pm (must be flexible to department needs)

Office location: Southgate Commerce Blvd in Orlando, FL

Travel: must be available to travel as needed, including to east coast and Alabama regions

To be considered:

*Must have experience with Medicare Hospital Outpatient Prospective Payment System (OPPS)*

*Must have 5 years of experience working within a revenue cycle department in a hospital and managerial experience*

Responsibilities

• Assigns and monitors staff workload to ensure goals are met on time and within budget and regulatory guidelines through approved methods and standards.
• Assists in annual budget projection and works within finalized budget and capital approvals.
• Provides resources as appropriate to assist other areas in the Revenue Cycle to complete projects.
• Delegates special projects to team members, advising them on goals and timeline. Follows through to ensure project completion.
• Expects direct reports to understand and professionally document process improvements.
• Ensures delivery of Executive Summaries to all appropriate parties in the revenue cycle.
• Maintains appropriate statistical information.
• Establishes and maintains intra/interdepartmental communication.
• Provides vision, direction, planning, and support to direct reports.
• Establishes rapport and maintains collaborative relationship with all team members.
• Recruits and retains qualified staff members to ensure visibility of the department at all campuses.
• Provides mentoring and career development to direct and/or indirect reports within the Revenue Integrity Department.
• Builds relationships with site Administration, CFO's and Managers within all revenue producing departments corporately.
• Expects and encourages direct reports to build relationships with Administration, CFO's, Managers and other contacts at all sites for all areas of responsibility.
• Leads direct reports to work collaboratively with IS, Nursing and Revenue Management leadership in the process improvement and implementation of charge capture opportunities.
• Develops relationships with various committees and groups to ensure continuity in processes that increase revenue capture.
• Communicates and interfaces professionally with other Managers and team members in the Revenue Integrity Department.
• Identifies communication opportunities between parties so that overlap of processes is minimized and overall workflow is enhanced.
• Creates a climate of empowerment and trust for direct reports. Manages Revenue Integrity employees with integrity, impartiality and responsiveness.
• Represents the Revenue Integrity department professionally and positively in both formal and informal settings by maintaining a high level of professional demeanor and dress at all times.
• Ensures direct reports assist all departments in understanding their responsibility to perform daily charge capture, and reconciliation processes for their departments.
• Holds Revenue Integrity team members to the highest standard of performance.
• Expects all Revenue Integrity team members present as premier examples for appropriate charge capture.
• Oversees all pricing and compliance methodologies are applied to charges according to regulations and corporate financial guidelines.
• Has a vision for Education and Training, as it pertains to the revenue cycle, charge capture and analytics and ensures all training material is accurate, audited and delivered in a professional manner.
• Oversees implements and monitors all training programs.
• Reports charge capture successes as they occur in charge entering areas.
• Oversees all pricing and compliance methodologies are applied to charges according to regulations and corporate financial guidelines.
• Directs an annual review of departments whose charges are grouped by APC, relative weight or any other level assignment to ensure validity of charging practices.
• Ensure revenue neutrality is maintained through performance of a gross/net revenue impact analysis on any change in charging practices. Communicates changes to all appropriate staff members impacted by the change in charging practices.
• Oversees implementation of all regulatory alerts, updates and Chargemaster changes. Ensures that direct reports understand the impact of changes, expected outcomes, and follow through with necessary charge management revenue process steps.
• Prepares revenue dashboards and reports. Monitors and presents as appropriate.
• Manages various human resources functions including hiring, work assignments, coaching plans, and performance counseling.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

Other Related Functions

• Maintain policies, procedures and manuals as appropriate.
• Ensures quality assurance processes are implemented and monitored for all areas of responsibility.
• Other duties as assigned.

Qualifications

Education/Training

Bachelor degree in business administration, finance, computer science or healthcare related field.

Experience

Must have expert knowledge of the Revenue Cycle in a hospital and have 5 years of experience working within a revenue cycle department in a hospital. Have knowledge of Medicare, Medicaid, Medicare OPPS reimbursement and other third-party billing rules and coverage. Have excellent regulatory resource capabilities. Must have managerial experience and have demonstrated ability to build teams and programs or similar experience. Able to manage several complex opportunities at one time.